Presentation on theme: "Newham Primary Psychological Services Neelam Dosanjh Head of Service Monton Jienpetivate Deputy Head Newham’s Model."— Presentation transcript:
Newham Primary Psychological Services Neelam Dosanjh Head of Service Monton Jienpetivate Deputy Head Newham’s Model
Newham Profile Population -308, 800 -High transient population -4 th most deprived borough in London Diversity - Young population - 60% aged between 25 and % are from different ethnic backgrounds, 130 languages Employment - Approximately 10% are unemployed double London’s average, no change post Second highest in benefit claims - 60% of ESA claimants report having mental health issues Health Inequalities
Service Profile Extended IAPT with specialist provision for LTC and MUS, Peri- Natal MH, Eating Disorders, Trauma Stepped Care Model – 0 to step 4a 7000 Referrals per year Approx into treatment Therapy choice is a priority but can’t always deliver due to capacity - CBT, DIT, IPT, Systemic, Integrative Sub contract to Third sector for counselling, a service for DV and welfare and employment
Drivers Mental ill-health is prevalent in the working age population and is associated with high economic and social costs to individuals and society at large. Improving the wellbeing of people with mental health problems and helping them find and sustained employment remains a challenge to health and employment services alike. Unemployment and being out of work are seen as key drivers behind mental ill-health (Pevalin and Goldberg, 2003; Paul and Moser, 2009). Employability and returning to work helps to improve mental wellbeing (Paul and Moser, 2009; McManus et al., 2012.
Profile of Service Users accessing Employment Service Length of depression and anxiety – 2 to 5 years Social isolation and exclusion Poor motivation and self esteem – extrinsically driven Low educational attainment Workless-ness in the family Co – morbidities – substance misuse, poverty, safeguarding issues, poor social stability (welfare), physical ill health
Integrated Model Barriers: To employment for people with mental health problems is the stigma and discrimination (Centre for Mental Health, 2013) Is the ‘benefit-trap’ when benefits create stronger incentives to remain in the system rather than return to work ( Lelliott et al., 2008) Integrated Provision: The integrated employment service within Newham IAPT offers opportunities to overcome these barriers Cultural shift : Therapists to assist the engagement SUs – suspicious, disengagement
Integrated Model - Benefits Provides social stability to better engage with the therapeutic process Ease of access for Service Users Learning, having a shared language and tailoring service provision Improves the Service User’s overall experience of care, engagement, quality, retention in employment and provides a longitudinal approach to improved well being
Integrated Model - Benefits Collaboration and close working ensures employment and wellbeing goals are aligned and realistic Employment service has excellent links with national and local employers and employer support services such as Access to Work The in work support provided by the employment service ensures early intervention for Service Users who are in work, and need additional mental health support to successfully retain their job.
Work of employment advisors Forming relationships with Service Users Assessing literacy and skills Employment steps - identifying competencies Coaching on motivation and confidence building Job searches – matching competencies Assisting with CV writing and application forms Preparing for interviews Employer engagement Liaising with educational and welfare agencies
Data for a year period- July 2013 to July 2014 Number of people referred for employment support % Number of people moving off sick pay and benefits21842% Total number moving from unemployment to paid work ( 15 self employment )408% Number moving from unemployment to part time or full time student9919% Number retaining full time work12424% Number retaining part time work367%
IAPT Employment Initiative Newham IAPT and local partnership Letwin pilot project: Newham IAPT engagement
IAPT Employment Initiative: existing partnership Local initiatives between Newham IAPT and Work Programmes set up in 2012 Initial meeting with all local main providers CDG and A4e signed up
IAPT Employment Initiative: Existing partnership Planning and pre-referral stage Establishing relationships with advisors and fostering engagement – Training provided by IAPT – Ongoing contact, consultation, follow-up and engagement Pathway mapping and Referral and infrastructure configuration Evaluation: Joined by UCL Partners
IAPT Employment Initiative: Existing partnership Success Relationship Commitment from staff from both sides Support and accessibility of IAPT staff to advisors Advisors increased confidence in their role and engagement with customers Challenges Learning each other’s “language” and system Governance, information sharing and data sharing Keeping on the task, and maintaining enthusiasm
Letwin Pilot Project: Aims “The purpose of the pilot is to test the impact on benefit off-flows of a client receiving support from the NHS (provided by IAPT). The focus will be Employment and Support Allowance (ESA) claimants in the Work Related Activity Group (WRAG) who report a common mental health condition that may impact on their ability to job search. These claimants will be engaged with the Work Programme.”
Letwin Pilot Project: Scope “Advisers to address job search and employment and establish if progress may be restricted by a common Mental Health Condition – advisers are not expected (nor should attempt to) to diagnose mental health conditions, but to identify where it impacts on Job search activities and employment and refer those who consent to the support.”
Letwin Pilot Project: Scope One thousand claimants Eight providers across the course of four months from September 14. The referrals will be voluntary and no sanctions can be applied for non-participation. Both existing claimants and new claimants of ESA.
Letwin Pilot Project: Newham IAPT engagement Preparation stage – Being “introduced” to selected partners – Seetec and CDG (Shaw Trust) – Process mapping, information sheets, data sharing, referral form and process – Weekly conference call/ feedback with the pilot team
Letwin Pilot Project: Newham IAPT engagement Local implementation – Active engagement “at the top” - Three-way meeting – IAPT, Primes and the project team – Negotiating a model, establishing contact points and referral route with management – Establishing and maintaining relationships Information session with advisors One-to-one, team consultation Maintaining contact – In-house communication, configuring IAPTus, referral pathway, tracking and engaging booking and clinical staff
Letwin Pilot Project: Newham IAPT engagement Two models A dedicated advisor as a link person – Meeting with local manager and the advisor to clarify aim of the project, criteria and secure commitment – Individual meeting with the advisor to help identify appropriate referrals – Regular contact All advisors make referrals – A half-day information session, including “refreshers” session of previous training and referral route – Establish referral handling, feedback and information sharing – Regular contact via dedicated team leader and individually about outcomes of referrals
31 Referrals received Dec 14 – Jan 15
Initial engagement outcomes
Current status 53% made it through to assessment completion; 47% dropped out at booking and pre-assessment
IAPT Employment Initiative: Letwin Pilot Project Learning points – Engagement and relationship is the key. – Commitment from the top is vital. – Be adaptive and understand our partners’ organisation needs and pressure, e.g. avoid training at the end of the month, multiple sessions as needed to ensure enough advisors on the ground to keep the business open. – Keep it simple. Advisors are busy and have a high caseload. – If plan A does not work, have a plan B in place. – Communication of outcomes – no-one would like to refer to a “black hole”. – Ensure a robust and referral handling and tracking system. – Engage and communicate with your own staff – clinical and booking team.